Senate Bill sb2570c2

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    Florida Senate - 2005                    CS for CS for SB 2570

    By the Committees on Health and Human Services Appropriations;
    Health Care; and Senators Jones and Bennett




    603-2305-05

  1                      A bill to be entitled

  2         An act relating to home medical equipment

  3         providers; amending s. 400.925, F.S.; revising

  4         and providing definitions; amending s. 400.93,

  5         F.S.; providing that physicians who sell, rent,

  6         or supply equipment or devices to their

  7         patients are exempt from licensure as a home

  8         medical equipment provider; amending s.

  9         400.931, F.S.; including additional categories

10         of equipment in a report required by applicants

11         for licensure; increasing the amount of

12         liability insurance required of home medical

13         equipment providers; amending s. 400.933, F.S.;

14         revising requirements for licensure and

15         assessment of fees; amending s. 400.934, F.S.;

16         revising minimum standards required for

17         licensure; amending s. 400.935, F.S.; requiring

18         the Agency for Health Care Administration to

19         provide additional regulatory standards by

20         rule; creating s. 400.936, F.S.; requiring

21         proof of accreditation as a prerequisite for

22         licensure or license renewal; providing for

23         temporary licensure; providing for rules

24         relating to designation of accrediting

25         organizations; amending s. 400.95, F.S.;

26         providing for notice of a toll-free telephone

27         number to report fraud and abuse by providers;

28         providing an effective date.

29  

30  Be It Enacted by the Legislature of the State of Florida:

31  

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    Florida Senate - 2005                    CS for CS for SB 2570
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 1         Section 1.  Subsection (1) of section 400.925, Florida

 2  Statutes, is amended, and subsections (17), (18), (19), and

 3  (20) are added to that section, to read:

 4         400.925  Definitions.--As used in this part, the term:

 5         (1)  "Accrediting organizations" means the Joint

 6  Commission on Accreditation of Healthcare Organizations, the

 7  Community Health Accreditation Program (CHAP), the

 8  Accreditation Commission for Health Care, Inc. (ACHC), or

 9  other national accreditation agencies whose standards for

10  accreditation are comparable to those required by this part

11  for licensure.

12         (17)  "High-tech medical equipment provider" means any

13  home medical equipment company that provides life-sustaining

14  equipment, technologically advanced equipment, or any other

15  similar equipment or product to any patient.

16         (18)  "Life-sustaining equipment" means mechanical

17  ventilators or other equipment that is essential to the

18  restoration or continuation of a bodily function important to

19  the continuation of human life.

20         (19)  "Technologically advanced equipment" means

21  equipment of such complexity that a licensed respiratory

22  therapist or registered nurse must set it up and train the

23  patient in its use.

24         (20)  "From its own inventory" means to provide the

25  items or service directly to the patient.

26         Section 2.  Paragraph (i) of subsection (5) of section

27  400.93, Florida Statutes, is amended to read:

28         400.93  Licensure required; exemptions; unlawful acts;

29  penalties.--

30         (5)  The following are exempt from home medical

31  equipment provider licensure, unless they have a separate

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    Florida Senate - 2005                    CS for CS for SB 2570
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 1  company, corporation, or division that is in the business of

 2  providing home medical equipment and services for sale or rent

 3  to consumers at their regular or temporary place of residence

 4  pursuant to the provisions of this part:

 5         (i)  Licensed health care practitioners who utilize

 6  home medical equipment in the course of their practice, but do

 7  not sell or rent home medical equipment to their patients, or

 8  physicians who sell, rent, or supply to their patients

 9  equipment or devices in the physicians' offices.

10         Section 3.  Paragraph (a) of subsection (2) and

11  subsections (6) and (7) of section 400.931, Florida Statutes,

12  are amended to read:

13         400.931  Application for license; fee; provisional

14  license; temporary permit.--

15         (2)  The applicant must file with the application

16  satisfactory proof that the home medical equipment provider is

17  in compliance with this part and applicable rules, including:

18         (a)  A report, by category, of the equipment to be

19  provided, indicating those offered either directly by the

20  applicant or through contractual arrangements with existing

21  providers. Categories of equipment include:

22         1.  Respiratory modalities.

23         2.  Ambulation aids.

24         3.  Mobility aids.

25         4.  Sickroom setup.

26         5.  Disposables.

27         6.  Life-sustaining equipment.

28         7.  Technologically advanced equipment.

29         (6)  The home medical equipment provider must also

30  obtain and maintain professional and commercial liability

31  insurance. Proof of liability insurance, as defined in s.

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    Florida Senate - 2005                    CS for CS for SB 2570
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 1  624.605, must be submitted with the application. The agency

 2  shall set the required amounts of liability insurance by rule,

 3  but the required amount must not be less than $300,000

 4  $250,000 per claim. In the case of contracted services, it is

 5  required that the contractor have liability insurance not less

 6  than $300,000 $250,000 per claim.

 7         (7)  A provisional license shall be issued to an

 8  approved applicant for initial licensure for a period of 90

 9  days, during which time a survey must be conducted

10  demonstrating substantial compliance with this section. A

11  temporary provisional license shall also be issued pending the

12  results of an applicant's Federal Bureau of Investigation

13  report of background screening confirming that all standards

14  have been met. If substantial compliance is demonstrated, a

15  standard license shall be issued to expire 2 years after the

16  effective date of the provisional license.

17         Section 4.  Subsection (2) of section 400.933, Florida

18  Statutes, is amended, and subsection (3) is added to that

19  section, to read:

20         400.933  Licensure inspections and investigations.--

21         (2)  The agency shall accept, in lieu of its own

22  periodic inspections for licensure, submission of the

23  following:

24         (a)  the survey or inspection of an accrediting

25  organization, provided the accreditation of the licensed home

26  medical equipment provider is not provisional and provided the

27  licensed home medical equipment provider authorizes release

28  of, and the agency receives the report of, the accrediting

29  organization.; or

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    Florida Senate - 2005                    CS for CS for SB 2570
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 1         (b)  A copy of a valid medical oxygen retail

 2  establishment permit issued by the Department of Health,

 3  pursuant to chapter 499.

 4         (3)  In addition to any administrative fines imposed,

 5  the agency may assess a survey fee of $500 to cover the cost

 6  of conducting complaint investigations that result in the

 7  finding of a violation that was the subject of the compliant

 8  and any followup visits conducted to verify the correction of

 9  the violations found in complaints.

10         Section 5.  Subsections (3), (4), and (18) of section

11  400.934, Florida Statutes, are amended, and subsection (20) is

12  added to that section, to read:

13         400.934  Minimum standards.--As a requirement of

14  licensure, home medical equipment providers shall:

15         (3)  Respond to orders received for other equipment by

16  filling those orders from its own inventory or inventory from

17  other companies with which it has contracted to fill such

18  orders; or by customizing or fitting items for sale from

19  supplies purchased under contract, except that high-tech

20  medical equipment providers shall fill all orders for

21  technologically advanced equipment directly from their own

22  inventory and shall not contract with any entity for the

23  delivery of such orders unless such entity is also licensed

24  and accredited pursuant to this subsection.

25         (4)  Maintain trained personnel to coordinate order

26  fulfillment and schedule timely equipment and service

27  delivery. High-tech medical equipment providers shall have on

28  staff, at a minimum, one licensed respiratory therapist, who

29  is either a certified respiratory therapist (CRT), a

30  registered respiratory therapist (RRT), or a registered nurse.

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    Florida Senate - 2005                    CS for CS for SB 2570
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 1         (18)  Maintain safe premises that are fully accessible

 2  to all patients between the hours of 9 a.m. and 5 p.m.

 3         (20)  Provide consumers with after-hours emergency

 4  service appropriately staffed by personnel equipped to offer

 5  necessary services to the public. High-tech medical equipment

 6  providers shall have on call, at a minimum, one licensed

 7  respiratory therapist who is either a certified respiratory

 8  therapist (CRT), a registered respiratory therapist (RRT), or

 9  a registered nurse.

10         Section 6.  Subsections (11) and (12) are added to

11  section 400.935, Florida Statutes, to read:

12         400.935  Rules establishing minimum standards.--The

13  agency shall adopt, publish, and enforce rules to implement

14  this part, which must provide reasonable and fair minimum

15  standards relating to:

16         (11)  The designation of equipment as life sustaining

17  or technologically advanced.

18         (12)  The designation of appropriate accrediting

19  organizations.

20         Section 7.  Section 400.936, Florida Statutes, is

21  created to read:

22         400.936  Mandatory accreditation.--

23         (1)  Effective January 1, 2006, all home medical

24  equipment providers licensed under this part shall submit to

25  the agency proof of accreditation as a prerequisite for

26  licensure or license renewal. Any provider that does not

27  submit proof of accreditation shall be issued a temporary

28  license and shall have 60 days to submit proof of application

29  to an accrediting organization. Such provider shall submit

30  proof of accreditation within 180 days after submitting an

31  application in order to receive a permanent license. Any home

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    Florida Senate - 2005                    CS for CS for SB 2570
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 1  medical equipment provider licenses as of January 1, 2006,

 2  shall have a reasonable period of time, not to exceed its next

 3  licensure renewal date, to comply with the accreditation

 4  requirement. Applicants that submit proof of accreditation, a

 5  completed licensure application, and the required fee may

 6  receive a temporary license until completion of the review of

 7  accreditation.

 8         (2)  The agency shall adopt rules designating

 9  appropriate accrediting organizations whose standards for

10  accreditation are comparable to those required by this part

11  for licensure.

12         Section 8.  Section 400.95, Florida Statutes, is

13  amended to read:

14         400.95  Notice of toll-free telephone number for

15  central fraud and abuse hotline.--On or before the first day

16  home medical equipment is delivered to the patient's home, any

17  home medical equipment provider licensed under this part must

18  inform the consumer and his or her immediate family, if

19  appropriate, of the right to report fraudulent, abusive,

20  neglectful, or exploitative practices. The statewide toll-free

21  telephone number for the central fraud and abuse hotline must

22  be provided to consumers in a manner that is clearly legible

23  and must include the words: "To report fraud, abuse, neglect,

24  or exploitation, please call toll-free 1-800-962-2873." Home

25  medical equipment providers shall establish appropriate

26  policies and procedures for providing such notice to

27  consumers.

28         Section 9.  This act shall take effect July 1, 2005.

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    Florida Senate - 2005                    CS for CS for SB 2570
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 1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 2                          CS for SB 2570

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 4  Provides an exemption from home medical licensure for
    physicians that sell, rent, or supply home medical equipment
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